CMS Price Transparency Data

Total hip replacement

Facility: Flowers Hospital

Billing Code: 27130 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 27130
  • Insurance Median: $12,506
  • Cash Discount Price: $17,950
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Total hip replacement at Flowers Hospital is $12,506. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,950. Compared to the federal Medicare reimbursement reference rate of $13,116.76, this hospital’s rate is 0.95x the Medicare baseline. Located in 4370 West Main Street, Dothan, AL.
Cash / Self-Pay
$17,950

Average discount available for prompt cash payment at this facility.

Insurance Median
$12,506

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$13,116.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $13,116.76 (100%)
Cash / Self-Pay: $17,950 (137%)
Insurance Median: $12,506 (95%)
Cash: $17,950 (137% of Medicare)
Ins. Median: $12,506 (95% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $13,116.76 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Veterans Eval Services $1,139 9%
Alabama Rehab $2,376 18%
Medicaid / KanCare $2,376 - $5,905 18%
Choicecare Commercial $3,500 27%
Viva Health $5,219 40%
Multiplan $5,578 - $95,731 43%
UnitedHealthcare $6,369 - $12,422 49%
Blue Cross Blue Shield $12,156 - $13,000 93%
Humana $12,156 93%
Medicare (plans) $12,156 93%
Node Viva Mcr Adv $12,156 93%
Select Health $12,277 94%
Compassionate Hands $12,368 94%
Covenant Hospice $12,368 94%
Dayspring Hospice $12,368 94%
Node Hospice Non Par $12,368 94%
Node Va $12,368 94%
Southern Care Hospice $12,368 94%
Vistacare Hospice $12,368 94%
Wiregrass Hospice $12,368 94%
Care Improvement Plus $12,399 95%
Cigna $12,399 95%
Node Devoted Health Mcr Adv $12,399 95%
Node Clover Health Mcr Adv $12,492 95%
Aetna $12,519 - $87,355 95%
Node Wellcare Mcr Adv $12,616 96%
Eon Health Care $12,763 97%
Prime Health $13,007 - $84,423 99%
Node Us Dept Of Labor $15,460 118%
Self Pay $17,950 137%
Ambetter / Centene $18,552 141%
Occunet $21,645 165%
S & S Healthcare $29,916 228%
American Employee Alliance $47,866 365%
Coventry Healthcare $59,832 - $91,375 456%
Standard Textile $83,765 639%
Alamed Wc $84,423 644%
Health Choice $87,355 666%
Equian $89,748 - $94,355 684%
Qhp $89,748 684%
Novanet $95,731 730%
Alabama Work Comp $99,321 757%
Ccn/Mednet Ppo $101,714 775%
Corvel $101,714 775%
Industry Buying Group $101,714 775%
Galaxy Health $107,698 821%
Health Payors Org $107,698 821%
National Provider Net $107,698 821%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4370 West Main Street, Dothan, AL 36302
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals